Chinese medicine （CM） is the most typical conventional therapy compared with any other traditional or alternative medicine systems. The active components of CMs are either primary or secondary metabolites generated ...Chinese medicine （CM） is the most typical conventional therapy compared with any other traditional or alternative medicine systems. The active components of CMs are either primary or secondary metabolites generated by metabolic and biosynthetic enzymes in plants, protecting the plants from environmental stress. The characteristics of these metabolites are diverse, complicated and unique. In this paper, current approaches for quality assessment were extensively reviewed, a new concept of quality marker （Q-marker） was then proposed for CM quality assessment. Additionally, definition of the Q-marker, as well as the relevant methods, were discussed, on the basis of the biosynthetic pathways of secondary metabolites and source of biological active components. Study design of Q-marker is complex system for quality assessment and production process control of CM products with transitivity and traceability. Therefore, the system with characteristics of transmission and traceability is expected to be established for regulation of quality. Upon the concept which the transitivity and traceability in the quality assessment and production process control covered the entire process, such as raw materials, decoction slices, processing, extraction and production can be further enhanced. The transitivity and traceability will inevitably require close attention to ＂who, what, where, when, and why＂ details at each stage of Q-markers of CM production form raw materials to patent product. The establishing quality standards are enablers of many and various transitivity and traceability solutions, not a solution in them. It means that the transitivity and traceability system is readily link between products and across borders in quality. According to the thinking mode and methods of investigation on quality assessment of CM product, we focus on the entire process, in terms of safety and effectiveness and quality control. The standard preparation of CM or CM decoction is not only the basis for study of Q-marker, but also the展开更多
Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and th...Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from展开更多
目的比较罗哌卡因和利多卡因对椎管内分娩镇痛下自然分娩后会阴疼痛的镇痛效果。方法纳入2016年2月至2017年4月我院产科74名经阴道分娩并接受椎管内分娩镇痛的足月单胎产妇,其中初产妇60例,经产妇14例。采用随机数字表法分为罗哌卡因组...目的比较罗哌卡因和利多卡因对椎管内分娩镇痛下自然分娩后会阴疼痛的镇痛效果。方法纳入2016年2月至2017年4月我院产科74名经阴道分娩并接受椎管内分娩镇痛的足月单胎产妇,其中初产妇60例,经产妇14例。采用随机数字表法分为罗哌卡因组和利多卡因组(n=37)。在会阴切开术或会阴修补术前进行0.75%罗哌卡因或1%利多卡因会阴局部浸润。用视觉模拟评分法(visual analogue score,VAS)对分娩过程中及分娩后会阴疼痛进行评价分级,并对产妇满意度进行评价。结果在注药后1 min (33 vs 26例,P=0.043),产后3 h (31 vs 20例,P=0.006)、4 h (27 vs 11例,P<0.001)、6 h (20 vs 0例,P=0.030),罗哌卡因组VAS为0的产妇多于利多卡因组,差异具有统计学意义(P<0.05)。分娩后坐立(11 vs 0例,P<0.001)、排尿(22 vs 3例,P<0.001)和睡觉(32 vs 24例,P=0.030)时,罗哌卡因组VAS评分为0的产妇人数均多于利多卡因组。罗哌卡因组对分娩镇痛满意的产妇(评价为非常满意和满意)多于利多卡因组(36 vs 29例,P=0.013)。罗哌卡因组和利多卡因组新生儿Apgar评分、脐动静脉pH值、碱剩余、乳酸含量、二氧化碳分压和血红蛋白含量组间比较差异均无统计学意义。结论罗哌卡因会阴浸润麻醉较之于利多卡因能提供更快和更长时间的镇痛,可显著提高椎管内分娩镇痛下自然分娩产妇的满意度。展开更多
AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to Jun...AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child's classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than 展开更多
Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcome...Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW） 〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.展开更多
Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national lev...Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%high展开更多
AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study ...AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study was performed to investigate the prevalence of NAFLD at baseline, and then the participants were followed for 8 years to investigate risk factors for the development of NAFLD.RESULTS: A total of 1948 participants were enrolled at baseline, of whom 691 were diagnosed with NAFLD. During the 8-year follow-up, 337 baseline NAFLD-free participants developed NAFLD. They had a greaterincrease in body mass index(BMI), serum uric acid, fasting plasma glucose, very low-density lipoprotein cholesterol and a considerable decrease in high-density lipoprotein cholesterol. 123 participants who had NAFLD at baseline lost NAFLD during the 8-year follow-up period. They had a greater decrease in BMI, fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase.CONCLUSION: NAFLD is prevalent in Chinese population with a rapidly increasing tendency. It can be reversed when patients lose their weight, control their hyperlipidemia and hyperglycemia, and reduce the liver enzyme levels.展开更多
There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessar...There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.展开更多
AIM： To investigate the expression of fragile histidine triad （FHIT） protein, and the possible relationship between FHIT expression and dinicopathological indices in gastric carcinoma. METHODS： FHIT protein expres...AIM： To investigate the expression of fragile histidine triad （FHIT） protein, and the possible relationship between FHIT expression and dinicopathological indices in gastric carcinoma. METHODS： FHIT protein expression was examined in 76 cases of gastric carcinoma, 58 cases of intraepithelial neoplasia, and 76 cases of corresponding normal mucosae by immunohistochemical method to analyze its relationship to histological grade, clinical stage, metastatic status and prognosis. RESULTS： The FHIT protein expression was positive in 28/76 （36.8%） cases of adenocarcinoma tissue, 22/58 （37.9%） cases of adjacent dysplastic tissue and 76/76 （100%） cases of distal normal gastric mucosa. There was a significant difference in the expression of FHIT protein between cancer or adjacent intraepithelial neoplasia and normal gastric mucosa （P = 0.000）. FHIT protein expression was found in 64.3% （18/28） of grades Ⅰ and Ⅲ cancers, and 20.8% （10/48） of grade Ⅲcancers （P = 0.000）, in 56.3% （18/32） of stages Ⅰ and Ⅱ cancers and 22.7% （10/44） of stages Ⅲ and IV cancers （P = 0.004）, and in 63.6% （14/22） of cancers without metastasis but only 25.9% （14/54） of those with metastasis （P = 0.003）. The significant difference in the expression of FHIT was found between histological grade, clinical stage and metastatic status of cancer. Follow-up data showed that there was a significant difference in median survival time between cancer patients with expression of FHIT （71 mo） and those without （33 mo, log rank = 20.78, P = 0.000）. CONCLUSION： FHIT protein is an important tumor suppressor protein. Loss of FHIT protein expression may be associated with carcinogenesis, invasion, metastasis and prognosis of gastric adenocarcinoma. 2005 The WJG Press and Elsevier Inc. All rights reserved展开更多
The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of ...The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.展开更多
AIM: To investigate the expression of fragile histidine triad (FHIT) gene protein, Fhit, which is recently thought to be a candidate tumor suppressor. Abnormal expression of fragile histidine triad has been found in a...AIM: To investigate the expression of fragile histidine triad (FHIT) gene protein, Fhit, which is recently thought to be a candidate tumor suppressor. Abnormal expression of fragile histidine triad has been found in a variety of human cancers,but little is known about its expression in human hepatocellular carcinogenesis and evolution.METHODS: Sections of 83 primary human hepatocellular carcionoma with corresponding para-neoplastic liver tissue and 10 normal liver tissue were evaluated immunohistochemically for Fhit protein expression.RESULTS: All normal liver tissue and para-neoplastic liver tissue showed a strong expression of Fhit, whereas 50 of 83(65.0 %) carcinomas showed a marked loss or absence of Fhit expression. The differences of Fhit expression between carcinoma and normal or para-neoplastic liver tissue werehighly significant (P=0.000). The proportion of carcinomas with reduced Fhit expression showed an increasing trend (a) with decreasing differentiation or higher histological grade (P=0.219); (b) in tumors with higher clinical stage Ⅲ and ⅣV (91.3 %, P=0.000), compared with tumors with lower stage Ⅰ and Ⅱ (27.6 %); and (c) in cancers with bigger tumor size (＞50 mm) (75.0 %, P=0.017), compared withsmaller tumor size (≤ 50 mm).
CONCLUSION: FHIT inactivation seems to be both an earlyand a later event, associated with carcinogenesis andprogression to more aggressive hepatocellular carcinomas.Thus, evaluation of Fhit expression by immunohistochemistryin hepatocellular carcinoma may provide important diagnosticand prognostic information in clinical application.展开更多
Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell...Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell adhesion molecule-1（VCAM-1）, which are associated with restenosis after PCI. Evidence suggests that microRNA-126 （miR-126） plays an important role in vascular inflammation, but its correlation with PCl-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods： We enrolled 130 patients with coronary artery disease （CAD） in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with 〉70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome （ACS） group （46 patients） and stable angina （SA） group （36 patients）. Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results： Plasma concentrations of hs-CRP and VCAM-I in patients with either ACS （n = 46） or SA （n = 36） were significantly higher than in controls （n = 48） （P 〈 0.01） prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCl. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion： There was a negative correlation of miR-126 with the P展开更多
基金National Natural Science Fundantion of China(No.81430096)
文摘Chinese medicine （CM） is the most typical conventional therapy compared with any other traditional or alternative medicine systems. The active components of CMs are either primary or secondary metabolites generated by metabolic and biosynthetic enzymes in plants, protecting the plants from environmental stress. The characteristics of these metabolites are diverse, complicated and unique. In this paper, current approaches for quality assessment were extensively reviewed, a new concept of quality marker （Q-marker） was then proposed for CM quality assessment. Additionally, definition of the Q-marker, as well as the relevant methods, were discussed, on the basis of the biosynthetic pathways of secondary metabolites and source of biological active components. Study design of Q-marker is complex system for quality assessment and production process control of CM products with transitivity and traceability. Therefore, the system with characteristics of transmission and traceability is expected to be established for regulation of quality. Upon the concept which the transitivity and traceability in the quality assessment and production process control covered the entire process, such as raw materials, decoction slices, processing, extraction and production can be further enhanced. The transitivity and traceability will inevitably require close attention to ＂who, what, where, when, and why＂ details at each stage of Q-markers of CM production form raw materials to patent product. The establishing quality standards are enablers of many and various transitivity and traceability solutions, not a solution in them. It means that the transitivity and traceability system is readily link between products and across borders in quality. According to the thinking mode and methods of investigation on quality assessment of CM product, we focus on the entire process, in terms of safety and effectiveness and quality control. The standard preparation of CM or CM decoction is not only the basis for study of Q-marker, but also the
基金This work was supported by the grants from China Postdoctoral Science Foundation （No. 20080431405＆ No. 200801041）.
文摘Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from
文摘目的比较罗哌卡因和利多卡因对椎管内分娩镇痛下自然分娩后会阴疼痛的镇痛效果。方法纳入2016年2月至2017年4月我院产科74名经阴道分娩并接受椎管内分娩镇痛的足月单胎产妇,其中初产妇60例,经产妇14例。采用随机数字表法分为罗哌卡因组和利多卡因组(n=37)。在会阴切开术或会阴修补术前进行0.75%罗哌卡因或1%利多卡因会阴局部浸润。用视觉模拟评分法(visual analogue score,VAS)对分娩过程中及分娩后会阴疼痛进行评价分级,并对产妇满意度进行评价。结果在注药后1 min (33 vs 26例,P=0.043),产后3 h (31 vs 20例,P=0.006)、4 h (27 vs 11例,P<0.001)、6 h (20 vs 0例,P=0.030),罗哌卡因组VAS为0的产妇多于利多卡因组,差异具有统计学意义(P<0.05)。分娩后坐立(11 vs 0例,P<0.001)、排尿(22 vs 3例,P<0.001)和睡觉(32 vs 24例,P=0.030)时,罗哌卡因组VAS评分为0的产妇人数均多于利多卡因组。罗哌卡因组对分娩镇痛满意的产妇(评价为非常满意和满意)多于利多卡因组(36 vs 29例,P=0.013)。罗哌卡因组和利多卡因组新生儿Apgar评分、脐动静脉pH值、碱剩余、乳酸含量、二氧化碳分压和血红蛋白含量组间比较差异均无统计学意义。结论罗哌卡因会阴浸润麻醉较之于利多卡因能提供更快和更长时间的镇痛,可显著提高椎管内分娩镇痛下自然分娩产妇的满意度。
基金the"9.5"National Major Project of National Committee of Sciences and Technology,No.96-907-03-02
文摘AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child's classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than
文摘Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW） 〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.
基金This study was supported by grants from the Ministry of Health-WHO five-year Cooperative Project on Influenza Surveillance in China,the Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences(grant no.U54 GM088558)a commissioned grant from the Health and Medical Research Fund,Food and Health Bureau,Government of the Hong Kong Special Administrative Region(grant no.HKS-15-E05).
文摘Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%high
基金Supported by the National Natural Science Foundation of China,No.81372425 and No.81460634the Key Lab Project of the Xinjiang Science and Technology Bureau,No.2014KL002
文摘AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study was performed to investigate the prevalence of NAFLD at baseline, and then the participants were followed for 8 years to investigate risk factors for the development of NAFLD.RESULTS: A total of 1948 participants were enrolled at baseline, of whom 691 were diagnosed with NAFLD. During the 8-year follow-up, 337 baseline NAFLD-free participants developed NAFLD. They had a greaterincrease in body mass index(BMI), serum uric acid, fasting plasma glucose, very low-density lipoprotein cholesterol and a considerable decrease in high-density lipoprotein cholesterol. 123 participants who had NAFLD at baseline lost NAFLD during the 8-year follow-up period. They had a greater decrease in BMI, fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase.CONCLUSION: NAFLD is prevalent in Chinese population with a rapidly increasing tendency. It can be reversed when patients lose their weight, control their hyperlipidemia and hyperglycemia, and reduce the liver enzyme levels.
基金The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104)National Natural Science Foundation of China(81827805,82130060)Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.
文摘There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.
文摘AIM： To investigate the expression of fragile histidine triad （FHIT） protein, and the possible relationship between FHIT expression and dinicopathological indices in gastric carcinoma. METHODS： FHIT protein expression was examined in 76 cases of gastric carcinoma, 58 cases of intraepithelial neoplasia, and 76 cases of corresponding normal mucosae by immunohistochemical method to analyze its relationship to histological grade, clinical stage, metastatic status and prognosis. RESULTS： The FHIT protein expression was positive in 28/76 （36.8%） cases of adenocarcinoma tissue, 22/58 （37.9%） cases of adjacent dysplastic tissue and 76/76 （100%） cases of distal normal gastric mucosa. There was a significant difference in the expression of FHIT protein between cancer or adjacent intraepithelial neoplasia and normal gastric mucosa （P = 0.000）. FHIT protein expression was found in 64.3% （18/28） of grades Ⅰ and Ⅲ cancers, and 20.8% （10/48） of grade Ⅲcancers （P = 0.000）, in 56.3% （18/32） of stages Ⅰ and Ⅱ cancers and 22.7% （10/44） of stages Ⅲ and IV cancers （P = 0.004）, and in 63.6% （14/22） of cancers without metastasis but only 25.9% （14/54） of those with metastasis （P = 0.003）. The significant difference in the expression of FHIT was found between histological grade, clinical stage and metastatic status of cancer. Follow-up data showed that there was a significant difference in median survival time between cancer patients with expression of FHIT （71 mo） and those without （33 mo, log rank = 20.78, P = 0.000）. CONCLUSION： FHIT protein is an important tumor suppressor protein. Loss of FHIT protein expression may be associated with carcinogenesis, invasion, metastasis and prognosis of gastric adenocarcinoma. 2005 The WJG Press and Elsevier Inc. All rights reserved
基金Supported by the key project of the 8th Five Year Plan of Scientific Committee of Guizhou Province(1993 No.2037)the key project of the"9th Five Year Plan”of Scientific Committee of Guizhou Province.(1996 No.1028)
基金funded by the National Basic Research Program of China (973 Program, 2014CB845700)the National Natural Science Foundation of China (Grant Nos. 11390371)Funding for the project has been provided by the National Development and Reform Commission
文摘The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.
文摘AIM: To investigate the expression of fragile histidine triad (FHIT) gene protein, Fhit, which is recently thought to be a candidate tumor suppressor. Abnormal expression of fragile histidine triad has been found in a variety of human cancers,but little is known about its expression in human hepatocellular carcinogenesis and evolution.METHODS: Sections of 83 primary human hepatocellular carcionoma with corresponding para-neoplastic liver tissue and 10 normal liver tissue were evaluated immunohistochemically for Fhit protein expression.RESULTS: All normal liver tissue and para-neoplastic liver tissue showed a strong expression of Fhit, whereas 50 of 83(65.0 %) carcinomas showed a marked loss or absence of Fhit expression. The differences of Fhit expression between carcinoma and normal or para-neoplastic liver tissue werehighly significant (P=0.000). The proportion of carcinomas with reduced Fhit expression showed an increasing trend (a) with decreasing differentiation or higher histological grade (P=0.219); (b) in tumors with higher clinical stage Ⅲ and ⅣV (91.3 %, P=0.000), compared with tumors with lower stage Ⅰ and Ⅱ (27.6 %); and (c) in cancers with bigger tumor size (＞50 mm) (75.0 %, P=0.017), compared withsmaller tumor size (≤ 50 mm).
CONCLUSION: FHIT inactivation seems to be both an earlyand a later event, associated with carcinogenesis andprogression to more aggressive hepatocellular carcinomas.Thus, evaluation of Fhit expression by immunohistochemistryin hepatocellular carcinoma may provide important diagnosticand prognostic information in clinical application.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81470024）, the Development and Reform Commission of Jilin Province （No. 2013C023）, and the Doctoral Fund of Ministry of Education of China （No. 2013061120051）.
文摘Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell adhesion molecule-1（VCAM-1）, which are associated with restenosis after PCI. Evidence suggests that microRNA-126 （miR-126） plays an important role in vascular inflammation, but its correlation with PCl-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods： We enrolled 130 patients with coronary artery disease （CAD） in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with 〉70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome （ACS） group （46 patients） and stable angina （SA） group （36 patients）. Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results： Plasma concentrations of hs-CRP and VCAM-I in patients with either ACS （n = 46） or SA （n = 36） were significantly higher than in controls （n = 48） （P 〈 0.01） prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCl. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion： There was a negative correlation of miR-126 with the P
